Provider Demographics
NPI:1710009253
Name:VOLUNTEERS OF AMERICA ASSISTED LIVING COMMUNITIES
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA ASSISTED LIVING COMMUNITIES
Other - Org Name:ELDER HOMESTEAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY, TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-941-0305
Mailing Address - Street 1:7530 MARKET PLACE DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3636
Mailing Address - Country:US
Mailing Address - Phone:952-941-0305
Mailing Address - Fax:952-941-0428
Practice Address - Street 1:11400 4TH ST N
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-3603
Practice Address - Country:US
Practice Address - Phone:952-933-1752
Practice Address - Fax:952-933-0730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN331597310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN49-80455OtherMEDICA
MNAL0075OtherUCARE MN
MN114924OtherHEALTHPARTNERS